Aghdam Nima, Pepin Abigail, Carrasquilla Michael, Johnson Colin, Danner Malika, Ayoob Marilyn, Yung Thomas, Lei Siyuan, Collins Brian T, Kumar Deepak, Suy Simeng, Lynch John, Collins Sean P
Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States.
George Washington School of Medicine and Health Sciences, Washington, DC, United States.
Front Oncol. 2020 Jan 22;9:1528. doi: 10.3389/fonc.2019.01528. eCollection 2019.
Retaining quality of life in patients treated with SBRT for prostate cancer remains paramount. As such, balancing the benefits of treatment against the effects of therapy on elderly patients is essential. The EORTC QLQ-ELD14 (ELD-14) is a validated questionnaire with a domain dedicated to burden of illness and treatment in the elderly. The Expanded Prostate Cancer Index Composite (EPIC)-26 is a validated questionnaire which measures urinary, bowel, sexual, and hormonal symptoms. This study reports trends in self-reported burden in patients with prostate cancer treated with SBRT and reveals convergence of self-reported burden with treatment related side effects obtained from the EPIC-26 questionnaire. All patients ≥70 years old, with localized prostate cancer treated with SBRT ± ADT at Medstar Georgetown University Hospital from 2013 to 2018 and had completed the ELD-14 were eligible for inclusion in this cross-sectional cohort study. Percentage of responses to questions related to disease and treatment burden were counted for each category ("not at all" and "a little" vs. "quite a bit" and "very much"). Additional demographic features were derived from available medical records. A total of 111 patients (median age of 74) responded to the ELD-14 questionnaire at onset of treatment and at the 2-year mark. Responses to EPIC questionnaires at matched follow-ups were scored and correlated with the self-reported burden domain of the ELD-14 using the Spearman correlation coefficient. Number of patients reporting "quite a bit" or "very much" burden from prostate cancer was 6.3% prior to treatment. This was highest at 1-month (10.8%) and decreased to 9.0% at 24 months post-SBRT ( = 3.836, = 0.6986). By comparison, 3.6 and 5.4% reported "quite a bit" or "very much" burden from treatment at start of treatment and 24 months, respectively ( = 1.046, = 0.9838). Patient reported treatment burden was found to converge well with individual domains of EPIC-26. Patients undergoing ADT experienced more burden than their non-ADT counterparts. This cross-sectional study suggests a minority of patients reported high burden from their clinically localized prostate cancer or from their SBRT treatment. Self-reported burden converged well with lower EPIC scores in multiple domains.
对于接受立体定向体部放疗（SBRT）治疗的前列腺癌患者而言，维持生活质量至关重要。因此，平衡治疗益处与治疗对老年患者的影响至关重要。欧洲癌症研究与治疗组织生活质量问卷ELD14（ELD - 14）是一份经过验证的问卷，其中有一个专门针对老年人疾病负担和治疗的领域。扩展前列腺癌指数综合问卷（EPIC）- 26是一份经过验证的问卷，用于测量泌尿、肠道、性和激素症状。本研究报告了接受SBRT治疗的前列腺癌患者自我报告负担的趋势，并揭示了自我报告负担与从EPIC - 26问卷获得的治疗相关副作用的趋同性。2013年至2018年在Medstar乔治敦大学医院接受SBRT±雄激素剥夺治疗（ADT）的所有≥70岁的局限性前列腺癌患者，且完成了ELD - 14问卷的，均符合纳入本横断面队列研究的条件。对与疾病和治疗负担相关问题的回答百分比按每个类别（“一点也不”和“有点”与“相当多”和“非常多”）进行统计。其他人口统计学特征来自可用的医疗记录。共有111名患者（中位年龄74岁）在治疗开始时和2年时对ELD - 14问卷做出了回应。在匹配的随访中对EPIC问卷的回答进行评分，并使用Spearman相关系数将其与ELD - 14的自我报告负担领域相关联。报告前列腺癌负担为“相当多”或“非常多”的患者在治疗前为6.3%。这在1个月时最高（10.8%），在SBRT后24个月降至9.0%（χ² = 3.836，P = 0.6986）。相比之下，分别有3.6%和5.4%的患者在治疗开始时和24个月时报告治疗负担为“相当多”或“非常多”（χ² = 1.046，P = 0.9838）。发现患者报告的治疗负担与EPIC - 26的各个领域很好地趋同。接受ADT的患者比未接受ADT的患者经历更多的负担。这项横断面研究表明，少数患者报告其临床局限性前列腺癌或SBRT治疗带来的负担较高。自我报告负担与多个领域较低的EPIC评分很好地趋同。
